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Duration of intravenous antibiotic therapy in people with cystic fibrosis

  1. Amanda Plummer1,*,
  2. Martin Wildman2

Editorial Group: Cochrane Cystic Fibrosis and Genetic Disorders Group

Published Online: 31 MAY 2013

Assessed as up-to-date: 27 MAR 2013

DOI: 10.1002/14651858.CD006682.pub4

How to Cite

Plummer A, Wildman M. Duration of intravenous antibiotic therapy in people with cystic fibrosis. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD006682. DOI: 10.1002/14651858.CD006682.pub4.

Author Information

  1. 1

    Northern General Hospital, Pharmacy Department, Sheffield, UK

  2. 2

    Northern General Hospital, Adult Cystic Fibrosis Unit, Sheffield, UK

*Amanda Plummer, Pharmacy Department, Northern General Hospital, Herries Road, Sheffield, S5 7AU, UK.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 31 MAY 2013



References to studies excluded from this review

  1. References to studies excluded from this review
  2. Additional references
  3. References to other published versions of this review
Adeboyeku 2011 {published data only}
  • Adeboyeku D, Jones AL, Hodson ME. Twice vs three-times daily antibiotics in the treatment of pulmonary exacerbations of cystic fibrosis. Journal of Cystic Fibrosis 2011;10(1):25-30. [CFGD Register: PI250]
Hjelte 1988 {published data only}
  • Hjelte L, Widen B, Malmborg AS, Freyschuss U, Strandvik B. Intravenous administration of antibiotics at home in patients with cystic fibrosis improves quality of life. Lakartidningen 1988;85(18):1614-7.
Hubert 2009 {published data only}
  • Hubert D, Le Roux E, Lavrut T, Wallaert B, Scheid P, Manach D, et al. Continuous versus intermittent infusions of ceftazidime for treating exacerbation of cystic fibrosis. Antimicrobial Agents and Chemotherapy 2009;53(9):3650-6.
Kapranov 1995 {published data only}
  • Kapranov NI, Belousov YB, Kashyrskaya NY, Smirnova EY. Quinoline therapy in children with cystic fibrosis [abstract]. Proceedings of 20th European Cystic Fibrosis Conference; 1995 June 18-21; Brussels, Belgium. 1995:P19.
Keel 2011 {published data only}
  • Keel RA, Schaeftlein A, Kloft C, Pope JS, Knauft RF, Muhlebach M, et al. Pharmacokinetics of intravenous and oral linezolid in adults with cystic fibrosis. Antimicrobial Agents and Chemotherapy 2011;55(7):3393-8. [CFGD Register: PI251]
Kenny 2009 {published data only}
  • Kenny S, Hall V, Goldsmith C, Moore J, Rendall JC, Elborn JS. Eradication of Pseudomonas aeruginosa in adults with CF [abstract]. Journal of Cystic Fibrosis 2009;8(Suppl 2):S39, Abstract no: 158.
Knight 1979 {published data only}
  • Knight RK, Batten JC, Mearns M. A double blind trial of cephalexin in cystic fibrosis patients with pseudomonas in the sputum [abstract]. Proceedings of 9th Meeting European Working Group for Cystic Fibrosis; 1979 June 12-13; Noordwijkerhout, The Netherlands. 1979:52.
Latzin 2008 {published data only}
  • Latzin P, Fehling M, Bauernfeind A, Reinhardt D, Kappler M, Griese M. Efficacy and safety of intravenous meropenem and tobramycin versus ceftazidime and tobramycin in cystic fibrosis. Journal of Cystic Fibrosis 2008;7(2):142-6. [MEDLINE: 87210211]
Postnikov 2007 {published data only}
  • Postnikov SS, Semykin SY, Polikarpova SV, Dubovik LG, Gracheva LA, Sagatelyan RM. A prospective trial on the efficacy and tolerability of twice-daily dosing (TDD) versus once-daily dosing (ODD) amikacin in cystic fibrosis patients [abstract]. Journal of Cystic Fibrosis 2007;6(Suppl 1):S34.
Riethmueller 2009 {published data only}
  • Riethmueller J, Ballmann M, Schroeter TW, Franke P, von Butler R, Claass A, et al. Tobramycin once- vs thrice-daily for elective intravenous antipseudomonal therapy in pediatric cystic fibrosis patients. Infection 2009;37(5):424-31. [CFGD Register: PI154f]
  • Riethmueller J, Junge S, Schroeter TW, Kuemmerer K, Franke P, Ballmann M, et al. Continuous vs thrice-daily ceftazidime for elective intravenous antipseudomonal therapy in cystic fibrosis. Infection 2009;37(5):418-23. [CFGD Register: PI154e]
Semykin 2010 {published data only}
  • Semykin SY, Polikarpova SV, Dubovik LG, Kashirskaya NY. Efficiency of the inhalational tobramycin therapy in complex antibacterial therapy of lung exacerbation in cystic fibrosis children with chronic pseudomonas aeruginosa infection [abstract]. Journal of Cystic Fibrosis 2010;9 Supplement 1:S55, Abstract no: 214. [CFGD Register: PI246]

Additional references

  1. References to studies excluded from this review
  2. Additional references
  3. References to other published versions of this review
Aaron 2005
  • Aaron SD, Vandemheen KL, Ferris W, Fergusson D, Tullis E, Haase D, et al. Combination antibiotic susceptibility testing to treat exacerbations of cystic fibrosis associated with multiresistant bacteria: a randomised, double-blind, controlled clinical trial. Lancet 2005;366(9484):463-71.
Accurso 1997
  • Accurso FJ. Early pulmonary disease in cystic fibrosis. Current Opinion in Pulmonary Medicine 1997;3(6):400-3.
Armstrong 1995
Balaguer 2008
Beaudry 1980
  • Beaudry PH, Marks MI, McDougall D, Desmond K, Rangel R. Is anti-Pseudomonas therapy warranted in acute respiratory exacerbations in children with cystic fibrosis?. Journal of Pediatrics 1980;97(1):144-7.
Burkhardt 2006
  • Burkhardt O, Lehmann C, Madabushi R, Kumar V, Derendorf H, Welte T. Once-daily tobramycin in cystic fibrosis: better for clinical outcome than thrice-daily tobramycin but more resistance development?. Journal of Antimicrobial Chemotherapy 2006;58(4):822-9.
CF Foundation 1994
  • Cystic Fibrosis Foundation. Microbiology and Infectious disease in cystic fibrosis. Consensus Conference, Bethesda 1994; Vol. V (Section 1):1-26.
CF Foundation 2001
  • Cystic Fibrosis Foundation. National Patient Registry. Annual Data Report 2000 [Bethesda, Maryland] 2001.
CF Trust 2009
  • UK Cystic Fibrosis Trust Antibiotic Group. Antibiotic treatment for Cystic Fibrosis. Report of the UK Cystic Fibrosis Trust Antibiotic Group. 3rd 2009.
Cheng 1996
  • Cheng K, Smyth RL, Govan JR, Doherty C, Winstanley C, Denning N, et al. Spread of beta-lactam-resistant Pseudomonas aeruginosa in a cystic fibrosis clinic. Lancet 1996;348(9041):1596-7.
Demko 1995
Dodge 2007
Donaldson 2003
Doring 2000
Döring 2012
  • Döring G, Flume P, Heijerman H, Elborn JS, Consensus Study Group. Treatment of lung infection in patients with cystic fibrosis: current and future strategies. Journal of Cystic Fibrosis 2012;11(6):461-79.
Edenborough 2004
  • Edenborough FP, Stone HR, Kelly SJ, Zadik P, Doherty CJ, Govan JR. Genotyping of Pseudomonas aeruginosa in cystic fibrosis suggests need for segregation. Journal of Cystic Fibrosis 2004;3(1):37-44.
Elborn 2004
Elbourne 2002
  • Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A. Meta-analyses involving cross-over trials: methodological issues. International Journal of Epidemiology 2002;31(1):140-9.
Emerson 2002
  • Emerson J, Rosenfeld M, McNamara S, Ramsey B, Gibson R L. Pseudomonas aeruginosa and other predictors of mortality and morbidity in young children with cystic fibrosis Pseudomonas aeruginosa and other predictors of mortality and morbidity in young children with cystic fibrosis. Pediatric Pulmonology 2002;34(2):91-100.
Frangolias 1999
  • Frangolias DD, Mahenthiralingam E, Rae S, Raboud JM, Davidson AG, Wittmann R, et al. Burkholderia cepacia in cystic fibrosis: variable disease course. American Journal of Respiratory and Critical Care Medicine 1999;160(5 Pt 1):1572-7.
Gibson 2003
  • Gibson RL, Burns JL, Ramsey RL. Pathophysiology and management of pulmonary infections in cystic fibrosis. American Journal of Respiratory and Critical Care Medicine 2003;168(8):918-51.
Gilligan 1999
  • Gilligan PH. Microbiology of CF Lung Disease. In: Yankaskas JR, Knowles MR editor(s). Cystic Fibrosis in Adults. Philedelpia: Lippincott-Raven, 1999:93-114.
Gold 1987
  • Gold R, Carpenter S, Heurter H, Corey M, Levison H. Randomized trial of ceftazidime versus placebo in the management of acute respiratory exacerbations in patients with cystic fibrosis. Journal of Pediatrics December 1987;111:907-13.
Hansen 2008
  • Hansen CR, Pressler T, Høiby N. Early aggressive eradication therapy for intermittent Pseudomonas Aeruginosa airway colonisation in cystic fibrosis patients: 15 years experience. Journal of Cystic Fibrosis 2008;7(6):523-530.
Hentzer 2001
  • Hentzer M, Teitzel GM, Balzer GJ, Heydorn A, Molin S, Givskov M, et al. Alginate overproduction affects Pseudomonas aeruginosa biofilm structure and function. Journal of Bacteriology 2001;183(18):5395-401.
Higgins 2003
Higgins 2011
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration 2011. Available from
Hodson 2000a
  • Hodson ME, Geddes DM. Cystic Fibrosis. 2nd Edition. Boston: Arnold, 2000.
Hodson 2000b
Hoogkamp 1983
  • Hoogkamp-Korstanje JA, van der Laag J. Piperacillin and tobramycin in the treatment of Pseudomonas lung infections in cystic fibrosis. Journal Antimicrobial Chemotherapy 1983;12(2):175-83.
Horre 2004
  • Horre R, Schaal KP, Siekmeier R, Sterzik B, de Hoog GS, Schnitzler N. Isolation of fungi, especially Exophiala dermatitidis, in patients suffering from cystic fibrosis. A prospective study. Respiration 2004;71(4):360-6.
Hyatt 1981
  • Hyatt AC, Chipps BE, Kumor KM, Mellits ED, Lietman PS, Rosenstein BJ. A double-blind controlled trial of anti-Pseudomonas chemotherapy of acute respiratory exacerbations in patients with cystic fibrosis. Journal of Pediatrics 1981;99(2):307-14.
Høiby 2000
  • Høiby N. Prospects for the prevention and control of pseudomonal infection in children with cystic fibrosis. Paediatric Drugs 2000;2(6):451-63.
Jones 2001
  • Jones AM, Govan JR, Doherty CJ, Dodd ME, Isalska BJ, Stanbridge TN, et al. Spread of a multiresistant strain of Pseudomonas aeruginosa in an adult cystic fibrosis clinic. Lancet 2001;358(9281):557-8.
Jones 2002
  • Jones AM, Dodd ME, Doherty CJ, Govan JR, Webb AK. Increased treatment requirements of patients with cystic fibrosis who harbour a highly transmissible strain of Pseudomonas aeruginosa. Thorax 2002;57(11):924-5.
Koch 1991
  • Koch C, Hjelt K, Pedersen SS, Jensen ET, Jensen T, Lanng S, et al. Retrospective clinical study of hypersensitivity reactions to astreonam and six other beta-lactam antibiotics in cystic fibrosis patients receiving multiple antibiotic courses. Reviews of Infectious Diseases 1991;13(Suppl 7):S608-11.
Kosorok 1996
Lechtzin 2006
  • Lechtzin N, John M, Irizarry R, Merlo C, Diette GB, Boyle MP. Outcomes of adults with cystic fibrosis infected with antibiotic-resistant Pseudomonas aeruginosa. Respiration 2006;73(1):27-33.
Master 2001
McLaughlin 1983
  • McLaughlin FJ, Matthew WJ, Strieder DJ, Goldman DA. Clinical and bacteriological responses to three antibiotic regimens for acute exacerbation of cystic fibrosis: Ticarcillin-tobramycin, azlocillin-tobramycin, and azlocillin-placebo. Journal of Infectious Diseases 1983;147(3):559-67.
Mendelman 1985
  • Mendelman PM, Smith AL, Levy J, Weber A, Ramsey B, Davis RL. Aminoglycoside penetration, inactivation, and efficacy in cystic fibrosis sputum. American Review of Respiratory Disease 1985;132(4):761-5.
Olesen 2006
Parmar 2005
Penketh 1983
  • Penketh AR, Hodson ME, Batten JC. Ticarcillin compared with carbenicillin in the treatment of exacerbations of bronchopulmonary infection in cystic fibrosis. British journal of diseases of the chest 1983;77(2):179-84.
Penketh 1984
  • Penketh A, Hodson ME, Gaya H, Batten JC. Azlocillin compared with carbenicillin in the treatment of bronchopulmonary infection due to Pseudomonas aeruginosa in cystic fibrosis. Thorax 1984;39(4):299-304.
Penketh 1987
Petersen 1981
Rabin 2004
Ramsey 1996
Rosenberg 1993
Schaedel 2002
Smyth 2005
  • Smyth A, Tan KH, Hyman-Taylor P, Mulheran M, Lewis S, Stableforth D, et al. Once versus three-times daily regimens of tobramycin treatment for pulmonary exacerbations of cystic fibrosis--the TOPIC study: a randomised controlled trial. Lancet 2005;365(9459):573-8.
Starner 2005
  • Starner TD, McCray PB Jr, American College of Physicians, American Physiological Society. Pathogenesis of early lung disease in cystic fibrosis: A window of opportunity to eradicate bacteria. Annals of Internal Medicine 2005;143(11):816-22.
Stuart 2010
  • Stuart B, Lin JH, Mogayzel Jr PJ. Early eradication of Pseudomonas Aeruginosa in Patients with Cystic Fibrosis. Review Article. Peadiatric Respiratory Reviews 2010;11(3):117-184.
Vic 1998
  • Vic P, Ategbo S, Turck D, Husson MO, Launay V, Loeuille GA, et al. Efficacy, tolerance, and pharmacokinetics of once daily tobramycin for pseudomonas exacerbations in cystic fibrosis. Archives of Disease in Childhood 1998;78(6):533-9.
Wat 2003

References to other published versions of this review

  1. References to studies excluded from this review
  2. Additional references
  3. References to other published versions of this review
Plummer 2011